Doctors, Hospitals, Health Concerns, oh my!

Well, it’s hard to believe we’ve been here for five months already. Miles’ and Jasper’s birthdays came and went, tax season is almost over (thank goodness for me), and I will be getting my dive certification soon. I’m supposed to start sometime after this Wednesday. Thankfully, most of our skin troubles seem to be clearing up. After countless different rashes, Jasper is looking more or less normal again. After trying a bunch of different remedies, it seems like in the end, his skin did the best when we stopped doing anything altogether. For the last week, we’ve just been washing him with soap every morning in the shower and have gotten the best results yet. We’ve stopped using bug spray on him, and to our surprise, he is hardly getting bit, even down at the Waqa’s where they don’t have screens on the windows. When I picked him up from there the other day, he did not have a single bite after running around all day. Yesterday after running around outside up by our house (where there are a TON of mosquitoes), he had only one bite. I am amazed and very glad—now we can stop using DEET (on Jasper anyway, I still get tons of bites).

Our number of encounters with the medical establishment of Fiji is growing. And boy are they interesting. Miles went to see Dr. Joeli, the only private doctor in town, last week. His clinic or “surgery” is in town, and the only other option for medical care is the hospital. Miles had a cold that he thought might be developing into an upper respiratory infection and possibly an ear infection. The doctor didn’t find any signs of infection (in the ears anyway, he didn’t really check anywhere else), so Miles came away with some Sudafed (hey, at least we know where to get it). The medications dispensed at the doctor’s office are frequently not in their original packaging, and are instead put in plastic baggies with a hand-written slip of paper with the name of the medication on it. Just a few weeks ago, John got such a bag with an antibiotic in it, some brown and black pills with the name scrawled on a slip of paper, plus another slip of paper with “2 pills, 3x/day” written on it. The best part was when we googled the name of the antibiotic and found two close matches, but no exact match for that name. But hey, it’s that or go to the hospital… plus the bill for Miles visit and a bunch of Sudafed was about $9 US.

This weekend, we chose the hospital. Sunday morning, Jasper was walking around with a cup of milk, when he tripped and fell. The glass broke, giving him several cuts on the arm and hand. One of the cuts on his arm was quite deep and Miles determined that it would need stitches. Since it was Sunday morning, our only choice was the hospital. I did not go, since I was sick and had to drag myself out of bed and try not to throw up while cleaning up the blood and glass, but Miles gave a report when they returned. Apparently, Miles wandered around the empty hospital for a while before encountering a nurse. When he told her his son was injured and asked her where the intake area was, she simply took them over to a nurse’s station, cleaned the wound, gave him an injection of a local anesthetic, and then attempted to stitch the cut. Apparently Jasper was just fine with the injection and sat there and stared as she gave it. But when she was doing the first stitch, he just went nuts crying and trying to get away. So he only got one stitch, instead of what probably should have been three. But it’s healing well, it’s not infected (miracle of miracles here in the tropics), and when Miles and the nurse determined there would be no further stitches, they just got up and went home. No paperwork, no wait, no money exchanged.

Now, the hospital does have an outpatient clinic, an “emergency room” of sorts, which I have seen. Miles just didn’t know where it was, and frankly, I’m not sure if it’s staffed on the weekends anyway. When I went there, it was with my friend, the Dutch nurse, and we gave ourselves a tour. The outpatient treatment area consisted of a long bench in the hallway, which people crammed together on while waiting to be seen, and a room behind the bench, where people were treated all in the same room. There was a table, where two doctors sat, each talking to a different patient (no confidentiality here), and then a curtain separating them from the area where the nurses gave care. When I was there, I made friends with one of the nurses on duty, and she chatted to me while we were about three feet away from a man getting an IV for dehydration. We were sitting on a hospital bed which I noticed was heavily stained with blood when I got up. No one was wearing gloves.

On the rest of our “tour” I saw the children’s ward, the men’s ward, the women’s ward and the OB room. The wards consisted of eight beds each, all in one room, four on one side of the hall, four on the other. I didn’t see any nurses around, except for the two from the outpatient clinic who came with us. The OB room was just that, one small dingy room with an ancient hospital bed, with an ancient fetal monitor and a broken incubator. In each of the wards there was a hand-written sign about making the budget stretch by washing all supplies and using them again. Everything except syringes was to be used again and again. Now I know there is a lot of waste in the way we do things, and many of the things used in our hospitals probably should be multi-use, but it came as quite a shock to me to see just how little there was by way of resources. Anna (the Dutch nurse) told me that she had been to the hospital the week before and had talked with a different hospital nurse and had asked her how they deal with crisis, with situations like not being able to revive a newborn, etc. She said the nurse seemed offended and answered with a snide tone, “we manage.” She probably thought this western, white nurse was looking down at the way they did things. But the truth is, she (and I) just wanted to know.

What is this thing on my arm?!

Oh the tropics, home to such interesting bacteria. Lately, Jasper and I have been battling various skin problems. I really have no idea what they even all are. Jasper has at least three different types of rashes, and I have a few different types of sores. I think the only one I can identify is heat rash (ok, ok, and the boils on Jasper’s head). We have been doing research and asking several of our friends about possible causes/remedies for the other rashes Jasper has been getting, with only a little success so far. At first, I thought his main rash, which is on his legs, arms, and face, was due to us spraying too much DEET on him, but other friends insist that they are from either flea bites or tick bites. Those friends (the Masirewas) definitely had some success in reducing the redness and swelling in his rashes by giving him an herbal medicine bath using guava leaves and volukaka. But we’ve been keeping him home, behind screens, away from animals, and he’s still had a few new eruptions (though definitely much reduced). One of the major problems, of course, is that he keeps scratching the sores. I can’t blame him, mine itch like crazy too, it’s just that they are not really healing because they keep getting re-opened. Miles is remaining unscathed (lucky duck), probably because he’s spent more time in Fiji in the past. He says he had all kinds of skin problems the time he was here for several months, and that after he went back to the states, they took about six months to resolve themselves. I really hope that our systems will adjust and that we will not be dealing with these for the rest of the time we spend here.

New month, new job, new dog

Sorry for the lack of posts; we’ve been so busy lately. It’s tax season and I’ve been trying to learn the Fiji tax system and get together all of the needed documentation, as well as starting another job.

Several weeks ago, I met a Dutch nurse/doula named Anna who was here visiting Gavin de Becker and his wife Yukimi, who live about 2 miles down the road from us. (Gavin is somewhat of a celebrity- he’s a security expert and has several best-selling books.) Gavin has a charity organization here in Fiji and has done a LOT for local villages and kids. Everything from helping with school uniforms and fees to providing medical supplies to remote villages. Anyway, I have been trying to figure out if there is any way for me to get involved in the birth scene here, and Anna wanted to see everything too, so it seemed like the perfect time to get out and meet people. We went to the hospital and met some of the nurses and toured the labor and delivery area (which consisted of one room at the end of the women’s ward, and was definitely NOT where I would ever want to give birth). The nurses were very nice, and I gave them my phone number and said that I would love to help in any way I could, or even just come and observe. Things happen very slowly here, though, and I have not talked to them for several weeks. More about the hospital later…

Spending time with Anna led to meeting Gavin and Yukimi, and after Anna left, Gavin told me that he wanted to start a school and wondered if I would be interested in helping out. I got pretty excited about it, and said that I would love to. So I have started working at the store Monday, Wednesday, and Friday, and spending Tuesday and Thursday at Gavin’s with a group of six kids. I’m not exactly sure where this project is going to go, so far it’s been very informal, more like drop-in child care than a school, but it’s still early on. I’m not sure if I will continue to be the teacher, since things at the store have gotten a little hectic since I stopped being there four or five days a week. I also have not had any time to myself to catch up on sleep (I’ve started drinking coffee out of necessity) or to study midwifery, which is very important to me, so I may propose stepping back and acting more as a consultant if Gavin still wants to move forward with the project.

One of the nice things about teaching has been having Jasper with me for those two days a week. We have been going through a somewhat difficult time lately with behaviors he is picking up at the babysitter’s house. Things are getting better now, but for a while, there was a lot of negativity at our house while Miles and I were trying to communicate to Jasper that some things were just not ok to do at our house. At the Waqa’s, and in Fiji in general, there is a different view of some behaviors we consider to be unacceptable, mostly involving hitting. I know it’s normal for kids (in the US) to go through an experimental phase with these things, where they try them out and see what the responses are, and they eventually learn that they are not acceptable. But here in Fiji, there’s a different attitude. Kids here hit each other all the time and it’s not considered violent or bad, but just funny. They smack each other on the behind, or they push each other, and just laugh. There is no negative association with this kind of behavior; it’s generally considered to be fun. This also applies to hitting animals. It’s not like they are beating each other or getting black eyes or anything, but when Jasper brings it home and hits me or the dog, I naturally get upset. For a while, I think he was confused about why we were so upset about it, because he was just doing it in fun, and not because he was angry or acting out. It’s just the message he was learning down the hill. After several weeks of trying to figure out how to deal with it, things are getting better. I think we’ve basically gotten the message across. We tried some time outs, but I don’t think they really worked. I think in the end, just explaining to him over and over that I don’t want to be hit, I don’t like it, and that I won’t play with him if he’s hitting me, got through to him and he’s pretty much stopped doing it. He’s still a little rough with the dog at times, but it’s definitely getting better.

Speaking of the dog, we got a little puppy near the end of January. She’s black with a little bit of white on her chest and paws, and she is very cute and very playful. Her name is Lai-Lai, which means “little” in Fijian. We got her from an Australian woman who found her on the side of the road in awful shape and nursed her back to relatively good health before putting up a sign to find her a home. We took Jasper over to meet her and he did very well with her, so we took her home. She is quite smart, and we have already taught her to stay away from cars (well, our car, which is the only one she’s around) and not to bark when we are getting her food ready. We are still working on getting her to be quiet and not whine to be let in at 4am.

Riding the Bus

Riding the bus here has been a sometimes confusing, strange, and hilarious endeavor. To get to and from work, we generally drive the truck (“the Mazda van with the open tray”) down the hill to the Waqa’s, park the truck and drop Jasper off, then catch whatever transportation comes along into town. I say whatever transportation, because it’s generally not a bus. The first day I decided to take the bus, I was riding in by myself because Miles’ ankle was still healing and he hadn’t started working at the store yet. Now, there is no office or visible oversight that runs the bus system, someplace you can get a bus pass or ask for a schedule. There are no written bus schedules. People just know when the busses run. There are also virtually no bus stops (I think I’ve seen two).

So that first day, I decided to walk down to the only bus stop around and just wait until a bus came along. I was encouraged to see people standing at the corner. Of course, I thought it was a bit strange that they were standing at the corner, instead of at the actual bus stop 50 feet away, but there were people waiting, which was a good sign. I asked one of the women there if she was waiting for the bus (she was) and if she knew what time it came. She said 10. I waited a minute, then looked at my phone to check the time. 9:10. What?! These people were waiting in the hot sun a whole hour before the bus came? I wasn’t wearing any sun block and didn’t have any with me, and the sun was already scorching hot. After about five minutes of fretting about sunburn, a truck with a canopy on the back drove up and stopped. One of the women jumped in the back of the cab like she knew the people. Then the woman in the passenger seat nodded at me. I looked around at the other two ladies and some men standing around waiting, then back at the woman in the truck with a questioning look. She nodded at me again, and I decided to jump in. I wasn’t going to miss a ride and have a nasty sunburn to show for it. I got in and the truck sped away. No one said a word. I really, really hoped they were going to town and not some other random place. Sure enough, the truck went to town, pulled over, and everyone got out. I saw the other two women give the driver some money, so I followed suit.

The next day, I went out to the same corner. This time, no one was waiting. So I stood there by myself, and after less than ten minutes, an empty taxi stopped. I didn’t wait for the nod, I just jumped right in. And that’s pretty much how it’s been most mornings. Just walk down the road, and eventually someone will pick you up. Usually it will be a taxi or “carrier” (the trucks with the covered bed; people sit in the back too), but we’ve also gotten free rides from the police and from a tow truck. I think the longest I’ve waited is 15 minutes, though Miles says one of the days he went without me he had to wait half an hour. And on one day out of the last two months, the first thing that went by was the bus.

Now in the afternoons, we almost always ride the bus. The bus costs 70 cents (which is also what a “return” ride into town costs), but a taxi home costs $3.50 (or so we’ve been told, we’ve never actually taken one). The buses leave from the bus station at roughly the same time every day, so we can plan when we leave the store. And I have to say that riding the bus is often one of the highlights of my day.
Things just happen on the bus. One day, the bus was still in town when a woman pulled the stop cord. The driver stopped, but nothing happened. He turned around, not looking surprised or annoyed, just neutral, and the woman who had pulled the cord pointed across the street and said, “My sister, my sister. She’s coming.” So the sister made her way across the street, had a short conversation with the woman on the bus, and then the woman on the bus passed her maybe three year old daughter to her sister through the window (there is no glass, the windows are just open holes). Another time, the bus stopped by the gas station and the guy getting off told the driver he just needed to get some gas really quick, so the driver just waited for him to get his gas and get back on the bus. And then there was the time that the bus stopped in the middle of nowhere, and in the distance I saw a girl walking toward the bus. I thought maybe she wanted to get on the bus, but she was walking really slowly for that. Eventually she made it to the bus and handed the driver what I’m assuming was his lunch through the window. He said thanks and we drove off. Riding the bus is never dull, that’s for sure. And then there’s the feeling of careening out of control as it takes sharp curves going downhill… yep, never dull.

Get your Goat

There is only one TV station here in Fiji, and a serious lack of programming for those who would like to watch. I'm ok with that, since we don't have a TV, and aren't really interested. Sometimes, though, we do watch the news with John and Barbara.

The local news (which is the same as the national news) is on every evening at six for between 20 and 40 minutes, depending on how much is going on. Here's a quip to give you an idea of average reporting:

"There’s a new form of soccer being played in Fiji. It's based around penalty shots, and is played with three players per team. Led by esteemed coach blah blah blah..."

The money quote at the end of the segment:

“The winner gets a goat, which proves the game is from Labasa.”

Ah Labasa, what a strange place.

Volukaka and Kana

Well, this wasn’t supposed to be a chronicle of Fijian medicine, but I keep getting sick, so there you go. This time around, I had something I wouldn’t call a flu, but it had muscle aches, headache, stomachache, nausea and diarrhea as symptoms. Once again, Eseta was concerned for my well being, and told Miles when he dropped Jasper off that she would pick some leaves for me to use. She also reiterated that I really need to be careful about being out in the rain. If I get caught in the rain, I need to wash it off. When I went down there today to drop Jasper off, she told me this again, and I said that I couldn’t remember being in the rain at all recently, and she said it happened when I walked home the other day. I said I didn’t think it was raining, and she replied “only a little bit, it’s still not good.” Maybe there was a slight drizzle. Being from Oregon, I couldn’t remember feeling any rain. This time, she gave me leaves from the volukaka or Simple-leaf Chastetree to pour boiling water over and inhale the steam. This time, I couldn’t find any good information online; even Wikipedia was not much help, but I went ahead and tried it anyway. I didn’t really notice any difference in how my stomach felt, but it did seem to help my head, and it felt refreshing. Good enough for me.


Yesterday we received a feast from Eseta’s family. A complete lovo meal (food cooked in an earthen oven with heated volcanic rocks), with two kinds of fish, dalo (taro roots), lolo (coconut cream sauce), palusami (dalo leaves stuffed with onions and lolo), chicken, lamb curry, and chop suey. Every time they have a lovo, they really load us down with food, enough for several nights’ dinners. This particular lovo (or more appropriately "kana" or feast) was in honor of Asenaca’s (Eseta’s next youngest sister) getting her first period and her transition into womanhood. There were probably fifty people over for dinner at the Waqa’s, and I have no idea how many others they gave food to. These people know how to throw a party, and I think it’s really awesome to celebrate this particular life transition in such a beautiful, life affirming way, surrounded by friends and family. What a gift to give to your daughter.

Look Ma, no Novocain! A dental horror/love story

Well, I meant to go to the dentist before we left the country, really I did. I had been having intermittent tooth pain for months, especially upon eating sweets. But somehow, there were just so many things going on, and I never got around to it. So we’d been in Fiji for maybe two weeks before I started asking John about dentists: specifically, were there any in the country that would not give me nightmares. My tooth was hurting, and I was afraid that I might have to remain in pain for a year or two, or pay a lot of money to fly over to Australia if I got desperate. Turns out there was a recommended dentist in Labasa (1.5-2 hours away depending on if you get stuck behind a bus and how much it’s raining). So I called and made an appointment, though I wasn’t exactly sure what kind of appointment I had made.

me: “I would like to make an appointment with the dentist.”
receptionist: “mumble mumble, [something about a] clinic.”
me: “I don’t know about a clinic. I live in Savusavu and I would like to come to Labasa to see the dentist.”
receptionist: “mumble mumble, what are you having?”
me: “I would like to have my teeth cleaned and examined. I am having some pain, and I think I might need a filling.”
receptionist: “mumble mumble, tomorrow?”
me: “How about Thursday?”
receptionist: “mumble mumble, [the only audible time I hear is] quarter past two.”
me: “OK, quarter past two. Thank you.”

So I go to Labasa and show up at the dentist’s office at the appropriate time. While I’m waiting, I look at the posted price list: tooth extraction (top of the list) $5-15, scaling and polishing (which turns out to be cleaning) $30-45, on down to root canal for a whopping $250. Well, I’d better not need one of those, because I didn’t bring $250.

I go into the dentist’s area and sit in the chair. Everything looks pretty normal: the chair with automatic raising and lowering, that light that’s always making you squint no matter how they adjust it, the tools and instruments. My first surprise: there’s no hygienist. The dentist does the cleaning himself. Normal procedure. Then the exam: the pain is apparently caused by a cavity and it just needs a simple filling. He gives me a mirror so I can see, and says “It’s a small one, I’ll just go ahead and take care of it right now.” I’m relieved I don’t have to come back. Then he gets out the drill and starts right in. Wait, no shot? No topical gel? No, I realize. There’s not going to be any of that, he’s just going to fill it up the fast way, and I get to sit there squeezing the hell out of my skirt and making fingernail imprints in my palms. And I get to watch. I still have the mirror, and I can see the whole thing. Somehow, though, seeing it is so fascinating that it helps with the pain. I’ve never seen a filling being done before, and I know exactly when it’s going to hurt. So he fills it up, using all the same high tech dentistry as in the US, giving me a white composite filling. It’s done, and then comes the clincher: “Well, it looked small, but it was really quite deep.” “No shit.” is all I can think.

I go back up front to pay, and it comes to a grand total of $70: 35 for the cleaning, 35 for the filling. Well, considering that that’s about $35 US, and that it probably would have cost 10 times as much to get it done in the States, I’m glad I waited and had it done here. Overall a positive experience, even without the Novocain.